Individual
MARRISSA C PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2014-00372
NC
208000000X
Pediatrics Physician
243167
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003145877A
PEACHCARE 4 KIDS
GA
05
—
003145877A
—
GA
05
—
02900278
—
NY
01
—
1083816912
HUMANA
NC
05
—
1083816912
—
NC
01
—
12669052
PHCS-MULTIPLAN
NC
01
—
1461884
WELLPATH
NC
01
—
186BW
BCBS OF NC
NC
01
—
2379703
AMERIGROUP
—
01
—
276479
MEDCOST, LLC
NC
01
—
2889619
UNITED HEALTHCARE
NC
01
—
4302375
COVENTRY NATIONAL - COVENTRY PPO
NC
01
—
9102458
AETNA
NC
01
—
9208288
CIGNA GREATWEST
NC
01
—
984960
WELLCARE
GA
01
—
FH1101660
FIRST CAROLINA CARE
NC
Enumeration date
06/04/2007
Last updated
11/12/2015
Update your record
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